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tv   Sanjay Gupta MD  CNN  April 1, 2012 7:30am-8:00am EDT

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will require surgery. the knicks say he will be out for six weeks, and that takes us through the end of the nba's regular season. health care reform many focus. you asked lots of questions this week as the supreme court heard the arguments. well, our dr. sanjay gupta has answers for you. dr. sanjay gupta m.d. starts right now. >> a medical mystery continues with new news about autism. cases are on the roois rise, and not just by a little bit. we'll tell you what we think is going on and also what to look for. also, a just retired top army general has a focus on an increasingly important issue, post traumatic stress disorder. i'm going to ask him about that soldier accused of mass murder in afghanistan. for three days unprecedented for a single case, justices argued about president obama's massive health care law. we've been getting lots of questions, which i'll try to
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answer in just a minute. first, let's get a quick recap. >> remember, the most controversial part of the law is the so-called individual mandate. that's the requirement that you carry insurance. is it constitutional? it's balancing the other part of the law that the insurance company must cover people who get sick. without healthy people in the system, companies say they would have to make rates, premium rates, sky-high for everyone, but critics say you can't force individuals to buy a private product like health insurance. the government says that's not it. everyone gets medical care sooner or later. requiring insurance is just a way to make sure that other people don't foot the bill. justice scalia didn't seem to buy this. >> how do you define the market that broadly? health care. it may well be that everybody needs health care sooner or later, but not everybody needs a heart transplant. not everybody needs a liver transplant. >> that's correct.
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you never know -- >> can you define a market that everybody has to buy food sooner or later, so you define a market as food, therefore, everybody is in the market. therefore, you can make people buy broccoli. >> that's a little bit of how it went. in fact, just minutes after that court session ended, cmn's jeffrey tubin came literally running down the steps with this. >> this was a train wreck for the obama administration. this law looks like it's going to be struck down. i'm telling you, all of the predictions, including mine, that the justices would not have a problem with this law were wrong. >> according to our latest cnn poll, the country is pretty of divided over mandatory health insurance. 47% in favor. 51% opposed. one in three american want the supreme court to completely overturn the current health care law. based on what we've heard, its fate is very much in question. i've been getting a lot of questions on how this could affect all of us or your family. i'm going to give it my best
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shot, and my producer danielle, who has been filtering through all the questions, is here to help. thanks for being on the show. >> thanks for having me. we've got hundreds of questions from people all over the country on our blog, on facebook, and twitter. >> it's hard to understand. not surprising. >> you're the best person since you've read the 2,700 page bill twice. >> right. >> let's get started. the first one comes from twitter. she says my daughter was dying moesd with a brain disorder. how will repeeling health care law affect preexisting conditions status? >> well, this is a somewhat tough question to answer. the way things stand now is people are not descriminated against based on preexisting conditions if they're a child. that will be true for all people by 2014. that's in play for now, and that's really important. if you didn't have that, getting health insurance plan with the preexisting condition could be prohibitively expensive. if the law is completely overturned, that's going to go away. she will have to give her insurance in the open market
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just like everybody else, and probably pay a lot more money for it. if the plan is severed, so the mandate goes away that some parts of the bill stay in effect, she could still have insurance, but it would be a little tricky in terms of how it would be paid for and who exactly would pay for it. >> here's the question. this one comes from twitter. there isn't preventive care that's supposed to be free? i received a bill last week after my weekly check-up. >> that's a good point. it is supposed to be free. you're supposed to have no co-pays or no additional fees, if it's a preventive screening. try not to prevent disease from happening. a couple of things could happen. september of 2010 is when this new plan went into effect many terms of making preventive screenings free. many f this person's insurance plan was before september of 2010, hasn't been modified since, they may still be grandfathered in without getting the preventive screenings for free, or, you know, it could be a little bit of a misunderstanding, which is the doctor thinks, look, this is a sick visit. the person came in for a
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specific problem. the patient thinks they're coming in for a preventive well visit, and that might be something this person should talk to their doctor about. how was this classified because, again, they're right. if it's preventive, it should be totally free. >> covered. >> all right. i think we have time for one more question. >> how am i doing? >> i love it. you're doing all right. there's so many to get to. this one is from facebook. he writes "i'm a medicare patient, and i received a check to help pay for my prescription drugs. will i get another one?" >> it's interesting. this is the donut hole that a lot of people sort of have heard about, maybe don't fully understand. if you imagine a donut, you eat through one side of the donut, and then you're in the hole, and then you go through the other side of the donut. it's the hole part that people are focused on. you get to -- once you make your way to the first part of the donut, you're being reimbursed, but in the middle of the donut hole you're not. this past year you would have got ain check for $250. going forward you wouldn't expect to get another check, to
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his question, but brand name drugs would be about 50% cheaper, and generics would be about 7% cheaper while he is in the middle of this donut hole. after he spends a certain amount of money on drugs, he would get those benefits until he spends a certain amount again. >> all right. >> it's a lot there. >> a lot there. i guess in june, that's when we'll get a decision on the supreme court. >> see which way it goes. >> thanks for being here. >> thanks for having me. >> appreciate it. >> we have a lot more to get to. >> up next, a highly anticipated report says cases of autism are on the rise. and it's happening past. [ male announcer ] this is lois.
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my inspiration for quitting were my sons. they were my little cheering squad. [ laughs ] [ male announcer ] ask your doctor if chantix is right for you. going under the microscope this morning, and a new report about autism. for the past 12 years the cdc has worked out regular estimates of how many 8-year-olds have autism. that's how they figure out these numbers. in 2000 and 2002, the number was more than 150. in 2004 one -- in 2006 it was one in 110. this week the latest cdc data as of 2008 shows that one in 88 children has autism. now, that's a 78% increase in
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just a decade. now, what this new report does not tell us is the question a lot of people have and that is why? why are these numbers going up? why are they going up so fast? researchers say part of it is better detection. they're noticing more cases, but that doesn't explain it all. a lot of you may have thought that as well. something is causing a real rise, and while studies are underway right now, we still don't know what that something is. there are things we do know. we know things about effective treatment. we know how important it is to spot the signs early, and treatment can help the most. here to talk more about that specifically is dr. gary goldstein. he is an autism specialist at the kennedy institute. thanks for being here. >> thank you very much. pleasure to be here. >> i want to ask you about some of the things at work because we try to be very solutions-oriented on this program, but i'm going to start off by asking what do you make of these new numbers? >> well, i was a bit surprised to see that the plateau hasn't
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yet been achieved. we're still seeing an increase every two years. >> you know, people have seen these numbers, and we just take them off as far as how rates -- when you look at the studies, does it giver you any more insight into causes from an environmental perspective or otherwise? >> we know your genes cannot change this quickly. genes change over thousands of years. not over a decade or two. we know even though there's strong genetic influences on autism that they cannot be responsible for the increase. >> so -- >> the other thing that's happened -- in the past decade there's been enormous number of really large genetic studies, and we're identifying genes, but the genes we identify, the changes in those genes, puts you at risk. they don't actually cause you to have -- some of them -- sometimes we find a gene that actually causes autism. more often the gene changes that are seen in children with autism
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make you prone to it, but something else has to be pushing you over. >> yeah. a lot of people are searching for what those environmentalal toxins are and what has changeed in our environment over the last decade, which to your point, is a more likely explanation given this rapid increase. for parents out there who have young children or are thinking about this more acutely, what do they look for? are there specific things that they can -- after listening to this program, they can be looking for? >> yes. i like to emphasize it is very important to make this diagnosis early. even if you make a decision that you are at risk and may not have autism, it's important to note early that there should be some intervention. we know early intervention works. >> i have a 2-year-old at home, and i have a 5-year-old and 6-year-old as well. 2-year-old -- my 2-year-old is like a lot of other 2-year-olds i imagine, but what should parents be looking for? >> i think what you should be looking for is social engagement. response to you as a parent.
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when your child -- you reach out to them, they want to be picked up by you. they like to be touched by you. they want you to be involved in what they're doing. this is even pre-verbal. before a child can talk, you can sense or you should be looking for a social interaction particularly with the care giving parent. usually the mother. and they're constantly interacting with you and looking for you. >> you make the case for early intervention, but if you can for a second, tell us what does that look like? what does a 2-year-old undergoing early intervention that could help, you know, some of these symptoms of autism? >> right. if you were to come to our classrooms at the greater institute you would see something that looks like a small classroom for a half a dozen 2-year-olds or 3-year-olds, and they would be going through various stages of interaction. some one-on-one with a therapist. other in small groups with three or four, and what the essence of
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it is that as that child makes eye contact, has any indication of being social and interactive, you try to reward them. get excited about it. blow bubbles at them. find out what it is that they respond to and reinforce the social behavior. >> dr. goldstein, this is something that we'll cover for a long time and we'll continue to do so. we appreciate your voice on this. thank you. >> thank you. >> coming up, shifting gears. a former top army general is taking on this new challenge. i wants to find help for soldiers with brain injuries and ptsd. i'm going to get his take on whether this may have played a role in the apparent mass killing by u.s. soldiers in afghanistan. one phillips' colon health probiotic cap a day helps defend against digestive issues with three strains of good bacteria. hit me! [ female announcer ] live the regular life. phillips'. [ female announcer ] live the regular life. nno matter what you do. when you're living with moderate to severe crohn's disease,
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we're learning more about the soldier accused of killing 17 sit sfwlenz in a shooting rampage in afghanistan. now, two senior u.s. officials said this week that staff sergeant robert bales snuck off his remote outpost twice during
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his alleged 90-minute rampage if two afghan villages. his attorney is suggesting that post traumatic stress disorder may be a factor, but that he is not going to go for an insanity defense. it is all pretty perplexing and very tragic as well. i wanted to talk to someone who is not only a four-star general, but someone who has dedicated his life to better understanding the stresses on the fighting men and women and what also happens to the brains. joining me now from los angeles is general peter. he retired from the military in january end aing four decade career of service. thank you for joining us this morning. you know, i followed your work and your comments over the years on ptsd and also the army's efforts to detect it and reduce the number of suicides as well in the armed services. you're retired now for a couple of months. is there another voice like yours at your level within the military? >> well, i think there is. i think everybody in the military is seized with the responsibility they have given
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ten years of war to look hard at post traumatic brain injury, and as i said before, the problem we have is we just don't have reliable diagnostic tools and in every instance to tell us whether or not a soldier is suffering from either one of those diseases of the brain. >> where does that leave us then? i mean, because obviously we are sending soldiers into these combat zones. we don't have the diagnostic tools. what do you do? how does one decide then who can go in, who should come out, those medical decision? >> well, there are dying mossic tools. i know you know that, but the problem is they don't provide the certainty of walking into a room with a blood pressure cuff and asking a group of people who has high blood pressure. now, we know there's stigma associated with behavioral health issues, and if you walked into that room and asked 100 people whether they had high blood pressure and nobody raised their happened, you could find out pretty quickly who, nobody d
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their hand, you could find out quickly, who, in fact, has high blood pressure and who doesn't with some certainty with that blood pressure cuff, but we don't have those same kinds of tools in determining whether someone has post-traumatic stress or post-traumatic brain injury. >> with all you've seen and heard over the years, what was your initial reaction when you heard about a u.s. soldier allegedly killing these afghan civilians? >> well, i mean, anyone who heard that, who has commanded, who understands the effect -- the expected effect of multiple deployments was concerned, as was i. but i've got to say, we've got thousands and thousands of soldiers, sailors, airmen, and marines, who have gone on multiple deployments and not had issues like occurred in afghanistan. so i think we really, really have to be careful of determining a cause and effect again because we just don't know enough.
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>> going back to bails, his lawyer said he wouldn't be going back for another tour, and then almost overnight received more orders. do you think that's a common situation or played any role here? >> again, i don't know anybody that wants to go back for multiple deployments to iraq or afghanistan. i know every single one of us who went on a multiple deployment was, in fact, concerned at a certain point in time. but that's why we serve. >> from a pragmatic standpoint, there's simply not enough men it will health professionals to do what we can do right now, to sort of push the knowledge that we do have right now. should we be doing more with what we know? if we're not doing that, are we simply pushing our soldiers too far, expecting too much from them without the support tools to give them? >> you know, the military
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services are the only people that i know that provide some kind of screening before a person deploys, while they're deployed, and when they come back. now, given all that, if the tools were more accurate, i would think have a better handle on this, but the tools just aren't that accurate. that's the issue we have today. >> i applaud your work. obviously, this is a great interest of mine. i think, obviously, being able to screen people so you have a comparison of the individual to that same individual as opposed to a shock then approach for these criteria is going to be really important. i know you know that as well. again, general, thanks for getting up early with us this morning. really appreciate your time. >> thank you. now, of course, brain trauma isn't just confined to the battlefield. up next, we'll introduce you to a woman whose life changed in an instant who was whacked by a car while riding a bike. outdoors, or in.
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in this morning's installment of the human factor, whacked, and then everything was different. it's an art exhibition with an unusual title meant to evoke what it's like to suffer a traumatic brain injury, recover, and then ultimately triumph. >> i was on my bike, and i heard this roaring car coming behind me. and i realized at that point the car was going to hit me. >> eight years ago, elliott markbine was hit by a car and flung in the air. >> while i was in the air, i was seeing central park on the left and people on the sidewalk going, my god, my god. i really thought those were the last thoughts and the last
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sights of my life. >> at the moment she slammed into the ground, markhbein's successful career as a journalist was over. >> my head was cracked open. >> words that once came easily were now garbled, and the pain readia iatiating through her bo became a daily sensation. she needed an outlet. >> i naturally started to take paper and pencils and color things and draw things, and i didn't have a tbi. my mind functioned seamlessly while i was doing art. >> eventually, art was not just a respite from pain but a new vocation. >> this is the central park jogger. >> years later, markhbein is still coping with her injuries, still feeling cathartic after she paints. her latest work in a new york art gallery depicts people who also had a tbi. >> this was alex. she was shaken as a baby.
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>> her process mirrors traumatic brain injury. first, a charcoal rendering of her subject. then markhbein cuts the work into pieces. >> here i have something that is beautiful and whole, and by cutting and taking scissors to it, i feel like i'm reinflicting the traumatic brain injury to that person. >> the next phase of the process, reassembling the image. >> so it's a parallel between the three phases of traumatic brain injury, which is fracture, reassemble, and whole. it shows all the scars that we have as a survivors of traumatic brain injury, whether they're emotional, whether they're physical, whether they're cognitive -- they're all part of that reassembled portrait. >> the result is larger than life portraits of people who, like markhbein, intensively rehabilitated both body and spirit and overcame. >> they're all i can hope that there is hope, do not ever lose hope. you will recover. you will do something with yourself. it's painful, but there is hope.
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>> and it's worth pointing out as well markhbein's exhibition will be displayed in art galleries across the coming months. her hope in these paintings is what she calls icons of hope, who inspire people living with tbi to become active participant ins their own recovery. before we go, news when it comes to chasing life this week. you're going to like this one. regular chocolate consumption has been limpged to lower bmi, which is body mass index, according to a new study. the results confirm the researchers' hypothesis that the metabolic properties of chocolate may offset the calories consumed. researchers believe it may be the caffeine and other ingredients. dark chocolate, in particular, is high in antioxidants, also anti-inflammatory properties. cocoa increase the hdl, good cholesterol and lower ldl, the bad cholesterol. you know what, don't go cr

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